The Union for International Cancer Control (UICC) has examined the National Cancer Control Plans and reported their findings in a new comprehensive global review published by Romero et al in The Lancet Oncology. The findings will be presented at the Cancer Planners Forum in May 2025 in Geneva, convening 100 national stakeholders to share best practices and knowledge for National Cancer Control Plan planning, development, and implementation. The forum will provide a platform for stakeholders to discuss the results and explore ways to enhance cancer control strategies globally.
Background
“Only about 10% of [patients with] cancer in low-income countries have access to radiotherapy compared to 90% in high-income countries, with approximately 20 out of 54 countries in Africa lacking any radiotherapy facilities. The integration of radiotherapy into cancer control strategies is more crucial than ever. This review highlights both the progress made and the gaps that persist, particularly in access to this lifesaving technology,” detailed senior review author Lisa Stevens, PhD, Director of the Division of Programme of Action for Cancer Control at the International Atomic Energy Agency and a member of the International Cancer Control Partnership (ICCP).
Review Methods and Findings
In the new review, a team of investigators from the UICC and the ICCP analyzed 156 national cancer and noncommunicable disease plans, encompassing countries across various income levels. They aimed to update global knowledge on the status and content of these plans, reflecting the rapidly changing landscape of cancer control and the impact of the COVID-19 pandemic.
The investigators demonstrated significant advancements in financing, specificity, early detection, and evidence-based recommendations since the previous review published in 2018—despite persistent challenges in funding and equitable access to cancer services, particularly in low-resource settings.
The inclusion of financing strategies in National Cancer Control Plans rose from 7% in 2018 to 27% in 2023, underscoring the growing recognition of the need for funded strategies to effectively combat cancer. There was also notable progress in the specificity and integration of National Cancer Control Plans, with many of the plans featuring clear targets and timelines, adhering to the SMART criteria. Although 90% of the plans included strategies for the early detection of breast and cervical cancers, just 50% of them included radiotherapy strategies, and a mere 26% of them referenced the World Health Organization’s Model Lists of Essential Medicines. This highlighted ongoing challenges in linking screening programs to timely treatment access. The investigators found that just 23% of National Cancer Control Plans and 12% of noncommunicable disease plans included a reference to evidence-based recommendations, indicating a critical area for improvement.
Despite these advances, the investigators identified persistent challenges in resource allocation and equitable access to cancer services. Disparities remained, particularly in low-income countries where funding for cancer control was still found to be insufficient. Ensuring equitable access to prevention, early detection, treatment, and palliative care services among all patient populations could remain an ongoing challenge.
“The advancements in early detection and treatment strategies as well as a greater inclusion of financing strategies … are particularly commendable. The fact that nearly 75% of plans, however, still do not include strategies to fund the cancer control ambition is disappointing. The progress in the number of detailed and well-coordinated plans is also encouraging because they include clear targets and timelines, which should lead, in time, to better outcomes in cancer control efforts. The gaps in accessing essential medicines and treatments, on the other hand, remain a global concern and show the need for continued international collaboration,” emphasized Cary Adams, BSc (Hons), MBA, Chief Executive Officer of the UICC.
Conclusions
The investigators suggested that cancer control plans could be strengthened by focusing on implementation strategies; securing adequate financing; ensuring a stronger evidence base for proposed interventions; and improving the link between screening, early detection, and timely treatment access. Additionally, enhancing international collaboration, increasing investment in cancer control, and leveraging technology and innovation may all be critical strategies to further improve National Cancer Control Plans.
“National cancer control plans are an opportunity to integrate current scientific knowledge into global cancer control policies and practice. Currently, only 23% of [National Cancer Control Plans] include evidence-based recommendations, highlighting an important area where dissemination and implementation of cancer research can impact policy and ultimately cancer care. This review also highlights the need for more research to understand effective implementation strategies for cancer policies, to ensure that [National Cancer Control Plans] are actively and equitably implemented in ways that improve cancer outcomes,” concluded Satish Gopal, MD, MPH, Director of the Center for Global Health at the National Cancer Institute and a co-convening member of the ICCP.
Disclosure: For full disclosures of the authors, visit thelancet.com.
